The spectacular mountain views in Garzê Tibetan Autonomous Prefecture, in the southwestern Chinese province of Sichuan, seem deliberately designed to provide the greatest possible juxtaposition with the lamentable state of the area’s public toilets. A stone’s throw from the soaring peaks of the plateau, a few rudimentary pits have been dug into the ground, surrounded by ramshackle wooden planks for privacy and protection from the elements. The floorboards groan ominously underfoot, a nerve-wracking reminder of your proximity to an ignominious fall from grace.

China’s public restrooms have long been a source of frustration for its people and the stuff of nightmares for tourists. Atrocious sanitary conditions, nostril-singeing odors, and a total absence of toilet paper are all common complaints.

But dirty toilets are not only off-putting — they’re dangerous, too. Every year, Buddhist ceremonies are held in Garzê, during which the local population explodes from about 10,000 to 200,000 people. The hastily assembled men’s restrooms have no urinals, meaning devotees simply go for a number one outside. By the end of the festival, the whole mountain reeks of urine, and runoff from the soil endangers the local water supply — an environmental problem that is decidedly un-Buddhist.

In recent years, ever-greater numbers of Chinese tourists have visited Japan, a nation that has refined public conveniences into an art form. Unlike in China, where the only thing students are taught about bathrooms is that one should wash their hands before eating and after using the toilet, Japanese students are given a comprehensive education in how to use the restroom.

Accordingly, we founded the Yuting Public Welfare Foundation in 2014. Our goal is to improve China’s restrooms, beginning in the country’s schools. We started by offering schools free toilet paper, in that hope that this would be a good way to influence the next generation of Chinese and get them thinking about health and safety issues.

Bathroom stalls in China typically come with a small wastepaper basket next to the toilet, beneath a sign on the wall asking users to throw their toilet paper into it. This method dates back to the ’80s, when toilet paper was often rough and crudely made, and some people simply used the daily newspaper. All this led to frequently clogged toilets.

Campus restrooms stink to high heaven, and students tend to go to the bathroom at once, meaning they are typically overcrowded.

- Qian Jun, public health advocate

Wastepaper baskets are a poor solution to this problem, and not just because they offend eyes and noses. In fact, these baskets are still in use only because of the kind of toilet paper used in most Chinese restrooms. Ordinary toilet paper is thin and thus dissolves quickly upon contact with water, reducing the chance of blockages. However, as Chinese restrooms do not generally come equipped with toilet paper, most Chinese instead use small packets of facial tissue, wet wipes, or — in cases of emergency — other paper, including newspapers. As these do not dissolve readily in water, they can easily clog up the pipes.

Our hope is that our efforts will lead China to universalize the provision of toilet paper in its public restrooms, thereby eliminating the need for wastepaper baskets and making the nation’s pipes clearer.

In 2014, our organization launched a pilot program at an elementary school in Kunshan, a city in eastern China’s Jiangsu province. Our initial estimates suggested that one child would go through about 17 yuan ($2.50) worth of toilet paper at school every year. The actual figure was far lower, with students using an average of only 8.6 yuan ($1.30) of paper in the first year, and the current average across all schools is a mere 5.5 yuan ($0.80).

We were perplexed that this figure was so much lower than our initial estimates. But in our follow-up survey, most students admitted that they were unwilling to use the bathrooms at school. The main reason? Campus restrooms stink to high heaven. In addition, since break periods are the same for all students, everyone tends to go to the bathroom at once, meaning they are typically overcrowded.

In the four years since we launched our program, we have made a number of adjustments. In order to strengthen student engagement and give them greater responsibility, we made some of them restroom monitors and told them to run their own toilets.

Students felt empowered by the responsibility and proved willing to volunteer for the role. But a couple of weeks later, a steady stream of parents rang up the school with the same question: “Why have you put my kid in charge of the bathrooms? Have they been causing trouble in class?” They thought it was some kind of punishment! In their minds, restrooms are filthy, a place only suited for taking care of life’s basic necessities. It never occurred to them that maintaining clean and tidy bathrooms requires everyone to be on board.

Our hope is that China will universalize the provision of toilet paper, thereby eliminating the need for wastepaper baskets and making the nation’s pipes clearer.

- Qian Jun, public health advocate

We have continued to try out new models for our project, with a focus on sustainability and giving more children the opportunity to participate. In June of last year, we hit on a new idea. Chinese students receive a lot of homework and go through several dozen pounds of paper in the form of homework notebooks, test books, and extracurricular books every semester. Most of this paper is not used very efficiently, so we decided to sponsor programs to recycle this waste paper and exchange it for toilet paper.

A normal elementary school has about 1,500 students. Together, they produce a minimum of five tons of waste paper on campus alone. This can be turned into 4.2 tons of recycled paper, sparing the equivalent of 85 trees, each 20 years old, from the logger’s ax. It also reduces carbon emissions produced in the manufacturing process by 1,130 kilograms per year. Yuting’s programs now reach 1 million students in 545 schools across 20 provinces.

China’s bathrooms still leave much to be desired. Sinks in many schools are too high, and younger students have to stand on their tiptoes or on stools just to wash their hands. Low cubicle doors mean many toilets are privacy-free zones, and some older campuses may have just one or two restrooms servicing the whole school.

We are currently working with Tsinghua University in Beijing to design ecologically friendly bathrooms for use in western China, with an eye toward improving the crude conditions of restrooms in the country’s less-developed interior. We are also in the planning stages of creating a museum dedicated to restrooms in order to draw more attention to these problems. After all, if no one kicks up a stink about this, we can hardly expect the problem to go away.